The embodiments herein relate generally to skin treatment compositions, and more particularly, to an extract composition for treating skin conditions, such as topical acne and rosacea.
Acne affects about 80% of Americans at some point in their lives. However, scientists know little about what causes the disorder and have made limited progress in developing new strategies for treating it. Dermatologists' arsenal of anti-acne tools, including benzoyl peroxide, antibiotics, and Accutane (isotretinoin), has not expanded in decades. Moreover, most severe cases of acne do not respond to antibiotics, and Accutane can produce serious side effects.
Antibiotics may not work for treating acne due to the phenomenon of antibiotic resistance, where individual bacteria develop resistance to an antibiotic by sheer random mutation. Most mutations kill bacteria so that they do not reproduce and pass the mutation to their progeny. However, some mutations give a single bacterium the ability to resist a medication.
An individual bacterium generally is not a problem. However, bacteria can reproduce as often as every 20 minutes, and bacteria have the ability to swap genetic material through a process called horizontal gene transfer. A bacterium can share its mutation with its neighbors by direct transfer of DNA. Thus, one resistant bacterium can become millions or billions and can spread from person to person, unhindered by treatment with the antibiotic to which it has acquired resistance.
When it comes to acne, doctors prescribe the medication, and acne sufferers tend to use it until their skin looks better, but not necessarily until all the bacteria are killed. Thus, the antibiotic just wipes out the most susceptible bacteria and leaves the resistant bacteria. When the patient stops taking the antibiotic, the resistant bacteria are free to multiply unchecked by competition from other microbes, and acne can actually come back worse than it was before treatment.
Acne bacteria have become resistant to many antibiotics, including Rifampin (to which 17% of acne bacteria are resistant), Tetracycline (to which 35% of acne bacteria are resistant), Amoxicillin (to which 40% of acne bacteria are resistant), Clindamycin (to which 50% of acne bacteria are resistant), Erythromycin (to which 52% of acne bacteria are resistant), Neomycin (to which 80% of acne bacteria are resistant), and Cloxacillin (to which 100% of acne bacteria are resistant).
While antibiotic resistance is a problem in treating acne, it is not the only issue. There is emerging evidence that the old idea that just one strain of bacteria, Propionibacterium acnes, causes acne is wrong. Acne experts in Asia are finding Staphylococcus aureus in pimples. However, the experts do not know whether the reason staph bacteria seem to contribute to acne in Asia has to do with Asian skin or Asian weather. This means, at least in Asia, at least two kinds of acne bacteria need to be controlled and that getting rid of one bacterium without getting rid of the second bacterium may just allow one strain to grow unchecked. It also means that impetigo, a staph infection that grows in cuts in the skin, may aggravate acne, which occurs in pores, and vice versa.
Because of the issues with antibiotics, more and more dermatologists are recommending that antibiotics should be just one part of acne treatment. Most skin doctors recommend using benzoyl peroxide to get rid of bacteria that antibiotics miss, but benzoyl peroxide comes with its own issues. For instance, benzoyl peroxide has been found to be very irritating for dry and sensitive skin types, and allergic reactions are extremely common. There is also compelling scientific data that shows that benzoyl peroxide users may age faster due to free radicals being formed during the manufacture of the benzoyl peroxide. Specifically, benzoyl peroxide is usually prepared by treating hydrogen peroxide with benzoyl chloride. Because the oxygen-oxygen bond in peroxides is weak, the benzoyl peroxide readily undergoes hemolysis (symmetrical fusion), forming free radicals.
Free radicals have strong bactericidal activity that works to kill any present bacteria, including both the bad bacteria forming the acne and any good bacteria that may be present on the skin. While benzoyl peroxide is not mutagenic, the Department of Environmental Health Sciences, John Hopkins Medical Institutions has found that benzoyl peroxide has been observed to produce strand breaks in DNA of exposed cells. Harvard Medical School and Wellman Laboratories of Photomedicine at Massachusetts General Hospital have published studies showing repeated chronic treatment with benzoyl peroxide caused changes that resemble those caused by low fluence UVB, which suggests that common inflammatory mechanisms may be involved in the production of the changes seen with chronic UVB or benzoyl peroxide exposure. The findings further support that oxidative stress plays a role in the photo aging process. Thus, while benzoyl peroxide may be beneficial for treating acne, it also breaks down the skin, accelerates aging, and compromises skin health.
Retinoids may also be prescribed to treat acne either in combination with benzoyl peroxide or on their own; however, use of retinoids is also fraught with side effects. Specifically, topical retinoids often cause a retinoid reaction characterized by itching, burning, reddening, and peeling. Retinoid use also causes photosensitization and may also cause teratogenicity or embryotoxicity in pregnant women if used systemically.
Therefore, what is needed is an extract composition that selectively suppresses bad bacteria that causes the skin disorders, while simultaneously enhancing good bacteria present on the skin, resulting in limited side effects and an enhanced skin microbiome.